BOA and BASK position statement on PHIN publication of knee replacement volumes
1- Wherever procedure volumes are published for primary knee replacement as part of patient information resources, these should be divided into the following three groups:
- Total Knee Replacement
- Patello-Femoral Replacement
- Unicondylar Knee Replacement
This will ensure that patients have information available about whether a particular
surgeon or unit regularly undertakes knee procedures other than total knee
replacement, if this is applicable to their situation.
2- The NJR already uses such a breakdown on the NJR Surgeon Hospital Profile site, based
on the advice of the BOA and BASK. PHIN publishing knee information in the same way
provides consistency of approach with this other major resource.
3- In our view and experience, patients are very often aware of the different knee
procedures that could be available when making their selection of hospital/surgeon,
particularly patients who are considering private treatment. The NHS Choices site for
example on its ‘knee replacement explained’ pages discusses both total and partial
knee replacement:
https://www.nhs.uk/Conditions/Knee-replacement/Pages/Whathappens.aspx.
4- PHIN requested advice on the OPCS coding to be used to make this division. The BOA
and BASK have considered this request but have concluded that we are not well placed
to advise on this issue. We particularly note that (1) there are ongoing changes to usage
of codes, on which the Department of Health are best placed to advise, and (2) the
different private providers submitting information to PHIN could be using codes in
various ways and with whom we feel you should liaise.
5- As a final point in relation to procedure volumes more widely, as previously indicated to PHIN, the BOA favours an approach in which consultants who practice both in the NHS
and independent sector have volume information published on their total practice in
order to provide a full description of the nature of their practice. Without this, those
with a small private practice may be disadvantaged by low numbers reported, and
patients are not presented with a true picture of the scale and nature of an individual's
practice. This low volume situation applies for example in the case of Patello-Femoral
Replacement and Unicondylar Knee Replacement mentioned above.